1194777805 NPI number — DR. ALLISON LESLIE HUGHES MD, PHD

Table of content: (NPI 1235187618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194777805 NPI number — DR. ALLISON LESLIE HUGHES MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES
Provider First Name:
ALLISON
Provider Middle Name:
LESLIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194777805
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2835 82ND AVE SE
Provider Second Line Business Mailing Address:
STE 210
Provider Business Mailing Address City Name:
MERCER ISLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98040-3055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-236-3030
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2835 82ND AVE SE
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
MERCER ISLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98040-3055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-236-3030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  4301079783 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , with the licence number: MD00044994 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 201981170 . This is a "WAUSAU" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 201981170 . This is a "HARRINGTON BENEFITS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 010E018410 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7729795 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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